Lumbar puncture alleviates chorea in a patient with Huntington’s disease and normal pressure hydrocephalus

Peyman Shirani, Alicia R. Salamone, Elham Lahijani, Michele K. York, Paul E. Schulz

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

A 44-year-old African-American male was admitted to our hospital after a suicide attempt. He had depression, poor cognitive function, choreiform movements, difficulty pronouncing words, and difficulty walking. His symptoms had worsened markedly over several months. Chorea lead to genetic testing that confirmed a diagnosis of Huntington Disease (HD). A CT scan of the head showed wider ventricles than is typical of HD. The head CT and gait change suggested normal pressure hydrocephalus (NPH). Lumbar puncture (LP) led to improved neuropsychologic test scores and walking thereby supporting the diagnosis of NPH. Surprisingly, the LP also led to an 80% improvement of chorea. There are two other reports of an association between HD and NPH. NPH should be considered in HD patients with atypical symptoms, such as the inability to walk or rapid progression, as its treatment may lead to improved cognition, gait, and chorea.

Original languageEnglish (US)
Pages (from-to)193-195
Number of pages3
JournalBehavioural Neurology
Volume21
Issue number3-4
DOIs
StatePublished - 2009

Keywords

  • Chorea
  • Huntington’s disease
  • Hydrocephalus

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Clinical Neurology

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